Is Ativan addictive?

Question

My primary care doctor prescribed Ativan (a brand name for lorazepam) for me a few months ago to help with episodes of extreme anxiety. He warned that because of its potentially addictive and harmful side effects and properties I should not take it more than as needed. My psychiatrist and his nurse decided to put me on a trial period of Ativan at 1.5 milligrams a day for one week, and they gave me the same warning about its addictive properties and promised that I would only use it temporarily. Yesterday, I went to my psychiatrist and he vehemently denied that it was addictive and instead said that:

Ativan isn't addictive due to its sedative side effects when you take more than needed

The above quote doesn't make sense to me because while it provides evidence that there are consequences for getting high off of Ativan, it doesn't provide evidence against a dependence on small amounts of the medicine. When I said that his office and my primary care doctor had said that it was addictive, he responded with something to the tune of the following:

Who do you trust more, someone who specializes in pyschiatry or your primary care doctor?

The above argument is an appeal to authority fallacy, but that doesn't invalidate his conclusion. Therefore, my question is: Is Ativan Addictive?

Answer 1

Well, drowsiness and sleepiness are common side effects according to the Mayo Clinic (not surprising considering it is a type of benzodiazepine or minor tranquilizer), but that doesn't mean it isn't addictive. The paper Relative abuse liability of lorazepam and diazepam: an evaluation in ‘recreational’ drug users concluded that lorazepam has addiction potential (or "abuse liability"):

The conclusion that lorazepam shares a relatively high abuse liability with diazepam is consistent with: (1) suggestions by clinicians that compared to other benzodiazepines, lorazepam has a particularly high addiction or dependence potential [19,20]; (2) increasing trends in the number of emergency room drug abuse mentions of lorazepam [21]; (3) ratings by sedative abusing methadone maintenance patients in an interview study which showed that the typical ‘high’ obtained from lorazepam was similar to that obtained from diazepam and higher than that produced by clorazepate, oxazepam and chlordiazepoxide (Iguchi and Griffiths, unpublished); (4) results from a double-blind drug evaluation in drug abusers which showed that lorazepam produced dose-related increases rating of liking, disposition to take the drug again and monetary street value [22] and (5) results from a double-blind drug evaluation in drug abusers which showed that lorazepam and diazepam produced significantly higher ratings of liking than did clorazepate and placebo [7].

And people do abuse it. The paper cites other studies that prove that:

A recent study of benzodiazepine abuse in the Federal Republic of Germany [29] permits comparison of relative rates of prescription with the number of reports on drug abuse and dependence over a comparable time-frame (1983). After correcting for differences in rates of prescription, the rate for lorazepam abuse/dependence is 4-7 times higher than that for oxazepam (cf. Tables 4 and 8 of Ref. 29). (3) In an interview study of benzodiazepine use among drug addicts in the United Kingdom [15], the rate of lorazepam mention (53.5% of the drug addicts interviewed) far exceeded that for oxazepam (1.4%).